Not Pregnant? Cut In Line for H1N1 Vaccine

Oct. 29, 2009

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"Extensive screening would require a burden of proof... This would not only waste time, it would discourage people from getting the vaccine by making the entire process longer and more frustrating for everyone involved," Paulson said. "And everybody who gets vaccinated protects the population as a whole, so the sooner everybody gets vaccinated, the better."

While they will vaccinate anyone who asks, Paulson said their strategy is to distribute the bulk of the vaccine to providers within target communities, such as pediatricians, family practitioners and OB-GYNs.

Gregory Poland, director of the Mayo Vaccine Research Group at the Mayo Clinic in Rochester, Minn., added that "the issue is that health care workers staffing these clinics are overwhelmed as it is -- they don't have time, nor should they be 'vaccine cops' doing detective work to determine is the person in front of them being honest."

Some Type of Screening Important, Doctors Say

Still, some doctors insist that a perfunctory screening method would not compromise efficiency or a patient's privacy.

"If priority strategies are to mean anything, they have to have teeth... Honor-based systems usually don't work, especially when health and life are involved," said Robert Field, a health law professor at Drexel University.

And several states have developed their own systems to ensure the majority of the people receiving H1N1 vaccines have the greatest need.

CDC Declined to Issue Screening Guidelines for Vaccine Distribution

Dr. Elizabeth Turnipseed, the medical director of infectious diseases for the Jefferson County Department of Health in Alabama, said public health clinics have plans in place to try and restrict the vaccine to high priority cases.

"We will not be asking people to prove their status in any of the groups, but at least to offer a compelling and plausible explanation," she said. "It is not a foolproof method, but we hope one that will be fair, reasonably efficient and possible to implement in a mass setting."

In some parts of New York and Washington and in Baltimore, health officials require those waiting for vaccine to fill out a signed form concerning risk conditions. In Wisconsin, vaccination clinics set up two lines for the H1N1 injection, one for those in high risk groups and one for everyone else.

CDC Fears Another Vaccine Stockpile

Still, the CDC may prefer not to actively restrict access to vaccination for fear of ammassing a stockpile of unused H1N1 vaccine, as happened in 2004, when a shortage of seasonal influenza vaccine resulted in strict allocations to high-risk groups only, after which demand fell.

But the demand for the H1N1 vaccine has not yet waned, which may not be desirable, according to Philip Alcabes, an infectious disease specialist at CUNY Hunter College, who argued that mass immunization was the wrong approach for dealing with the virus.

"The vaccine is good but far from perfect at protecting against infection," Alcabes said. "It doesn't reduce infectiousness of those people who do get infected despite immunization, and people who are in 'priority' groups for immunization are in constant contact with people who are not immunized. It's a flawed strategy at best."

In addition, Alcabes pointed out that ceaseless advisories about H1N1 from federal agencies may have raised public awareness about what is a mild virus for the majority of the population -- though a real threat to some -- to something catastrophic.